Pseudomonas aeruginosa otitis

Re: Pseudomonas aeruginosa otitis

stuart mcmorrow — Wed, 25 Nov 2009 23:06:18 GMT

manuka honey can work for this

Re: Pseudomonas aeruginosa otitis

David Bentley — Sat, 31 Oct 2009 16:59:29 GMT

Despite fluoroquinolone resistance in culture, it is generally considered that the concentrations of topical fluoroquinolones made up by a practioner eg 16ml Baytril in a 100ml bottle of Triz EDTA (Dermapet), can overcome resistance. Tris EDTA can help the antibiotic penetrate the bacterial cell wall. Silver sulphadiazine (Flamazine cream) diluted about 1:8 with saline and instilled into the ear canal daily can also kill pseudomonas.

If the TM is ruptured and the middle ear infected, then systemic tmt is recommended and I have successfully used genticin injection daily s/c in 3 cases. Ticarcilin is often effective but needs to be given i/v tid! ( forgotten dose rates as at home) . with sytemic gentamcin I check renal funtion 2-3 times during a course of tretment lasting 2 weeks or so. Middle ear flushing using a video otoscope is often necessary with these with a ruptured TM amd otitis media. Also the inflammation with pesudomonas otitis has to be controlled quickly and pred at 1-2mg/kg sid for 2-3 weeks is often necessary. Its is probable that you can't evaluate the condition of the TM due to stenosis--let the pred work and rx when the canal is open.

Re: Pseudomonas aeruginosa otitis

Jillian Hall — Sat, 31 Oct 2009 11:25:39 GMT

You should have a chat with the virbac advisors. Eas-otic contains gentamicin and obviously isn't licensed in the face of a ruptured TM, but what it comes down to is a risk benefit analysis. I was talking to Virbac recently about the product and he was saying all the ototoxicity concerns about gentamicin are based on systemic use and it's presence locally in the middle ear isn't the end of the world. Yes it can cause toxicity, but so can just about everything else, including saline. The gentamicin may not be more ototoxic than a heavy load of Pseudomonas anyway.

If the dog is refractory to everything else then off-label use of topical gentamicin could still be justified. From what I've heard I wouldn't gonear systemic gentamicin - nasty stuff.

Obviously that's in addition to other standard approaches to severe otitis ie GA ear flush, Xray middle ear etc. But I would still contact virbac as they've plenty of data on the on/off label use of gentamicin down ears.